The Surviving Sepsis Campaign And The Hour-1 Bundle

The Surviving Sepsis Campaign and the Hour-1 Bundle

The Surviving Sepsis Campaign (SSC) is an international collaborative initiative that produces evidence-based guidelines for sepsis management, updated every four years. The 2018 Hour-1 Bundle — subsequently updated — reflects the recognition that early intervention in sepsis dramatically improves outcomes, in the same way that door-to-balloon time in STEMI and thrombolysis time in stroke do. Every hour of delay in antibiotic administration in septic shock is associated with a measurable increase in mortality.

The Hour-1 Bundle — Do All of These Within 1 Hour of Sepsis Recognition
1.  Measure lactate. Remeasure if initial lactate >2 mmol/L
2.  Blood cultures before antibiotics — two sets from separate sites
3.  Broad-spectrum antibiotics — do not delay for culture results
4.  30 mL/kg IV crystalloid for hypotension (MAP <65) or lactate ≥4 mmol/L
5.  Vasopressors if hypotensive during or after fluid resuscitation — target MAP ≥65 mmHg